CommercialMedicare AdvantageMedicaidJuly 1, 2024
July 2024 Provider Newsletter
Administrative
CommercialMedicare AdvantageMedicaidJune 18, 2024
Phoenix Sepsis Criteria for coding and billing pediatric sepsisMedicaidJuly 1, 2024
Anatomical modifiersCommercialJuly 1, 2024
Recovery room — facility editing updateCommercialJuly 1, 2024
Anesthesia modifiers — professional editing updateCommercialJuly 1, 2024
Timely receipt of other carrier EOB or rejection helps avoid timely filing denialsCommercialJuly 1, 2024
Drugs and biologicCommercialJuly 1, 2024
CAA: Maintain your online provider directory informationCommercialJuly 1, 2024
Address change for claims submissions and correspondenceCommercialJuly 1, 2024
CMS drug fee schedule update — third quarter 2024CommercialJune 20, 2024
Digital-only authorization case status notification coming to youEducation & Training
CommercialJune 13, 2024
Faster notification of EDI corrected claims errorsCommercialMedicare AdvantageJuly 1, 2024
July is Disability Awareness MonthCommercialMarch 12, 2024
Important reminder: The correct original claim number must be included if submitting a corrected claimCommercialMedicare AdvantageMedicaidJuly 1, 2024
Introducing advanced eLearning features for MyDiversePatients.comPolicy Updates
MedicaidJune 4, 2024
InterQual 2024 March updatesMedicare AdvantageJune 3, 2024
Clinical Criteria updates — November 2023MedicaidJune 11, 2024
Clinical Criteria updates — December 2023MedicaidJune 4, 2024
Carelon Medical Benefits Management, Inc. updatesMedicare AdvantageMay 29, 2024
Carelon Medical Benefits Management, Inc. updatesMedicare AdvantageJune 13, 2024
Updates to Carelon Medical Benefits Management, Inc. Clinical Appropriateness Guidelines effective October 20, 2024CommercialJune 21, 2024
Clinical UM Guidelines notificationCommercialJune 10, 2024
Medical Policy and Clinical Utilization Management Guidelines notificationMedicare AdvantageMay 30, 2024
Medical Policies and Clinical Utilization Management Guidelines updateEffective July 1, 2024
CommercialJune 19, 2024
Carelon Medical Benefits Management, Inc. genetic testing code updatesCommercialJuly 1, 2024
Precertification list change notification July 1, 2024MedicaidJune 11, 2024
Prior authorization requirement changesEffective August 1, 2024
Codes 81173, 81247, 81249, 81307, 81336, 81403, 81405, and 81440
CommercialJuly 1, 2024
Reimbursement policy update: Frequency Editing — ProfessionalCommercialJuly 1, 2024
Reimbursement policy update: Incident to Services — ProfessionalProducts & Programs
CommercialJuly 1, 2024
Antidepressant Medication Management (AMM)MedicaidJune 18, 2024
Prior authorization updates for medications billed under the medical benefitMedicare AdvantageJune 20, 2024
Anthem expands specialty pharmacy precertification listCommercialJuly 1, 2024
Correction: Specialty pharmacy updates — July 2024Quality Management
MedicaidJuly 1, 2024
Important information about utilization managementMedicaidJuly 1, 2024
Member Rights and Responsibilities sectionMedicare AdvantageJuly 1, 2024
Understanding your role in the Health Outcomes SurveyCommercialMedicare AdvantageMedicaidJuly 1, 2024
New resources to improve your HEDIS® and CAHPS® quality ratesNVBCBS-CDCRCM-061284-24
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